The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure.
The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure.
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DOI：
10.2147/ppa.s95528
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发表时间：
2016
影响因子：
2.2
通讯作者：
Hughes JW
中科院分区：
文献类型：
--
作者：
Dolansky MA;Schaefer JT;Hawkins MA;Gunstad J;Basuray A;Redle JD;Fang JC;Josephson RA;Moore SM;Hughes JW
虽然认知障碍在心力衰竭（HF）患者中很常见，但其对钠依从性建议的影响尚不清楚。我们的目的是检查认知功能是否与患者的钠依从性相关。在5 - 8周内评估了339名HF患者的钠收集/排泄和认知功能。在基线（访视1）时进行神经心理学测试，而在基线后7周内采集两份24小时尿液样本。收集两个24小时尿液样本的能力和从这些样本中估计钠排泄水平用于估计钠依从性建议。近一半（47%）的研究参与者（n = 159）无法提供两个有效的24小时尿液样本。无法坚持两次有效24小时尿液样本的参与者的注意力和整体认知测试明显较差（P <0.044），执行功能也有较差的趋势（P = 0.064）。在有效样本中，校正协变量后，尿钠水平与整体认知功能、注意力、执行功能或记忆力无关。女性与较低的钠排泄相关（所有P <0.01）;了解钠指南的个体钠摄入量较少，导致钠排泄量较少（所有P ≤ 0.03）。相反，较高的社会经济地位（SES）和体重指数（BMI）与较高的钠相关（所有P ≤ 0.02和P ≤ 0.01）。对尿钠收集的依从性较差，尤其是那些认知功能较差的患者。钠摄入量超过推荐量，与认知功能无关。改善钠依从性的干预措施应侧重于高危人群（高SES和BMI），并提高对推荐盐摄入量的认识。
Although cognitive impairment is common in heart failure (HF) patients, its effects on sodium adherence recommendations are unknown. Our aim is to examine if cognitive function is associated with patient sodium adherence. Sodium collection/excretion and cognitive function were assessed for 339 HF patients over a 5–8-week period. Neuropsychological testing was performed at baseline (Visit 1), whereas two 24-hour urine samples were collected within 7 weeks postbaseline. The ability to collect two 24-hour urine samples and the estimation of sodium excretion levels from these samples were used to estimate sodium adherence recommendations. Nearly half (47%) of the study participants (n=159) were unable to give two valid 24-hour urine samples. Participants who were unable to adhere to two valid 24-hour urine samples had significantly poorer attention and global cognition tests (P<0.044), with a trend for poorer executive function (P=0.064). Among those with valid samples, urine sodium level was not associated with global cognitive function, attention, executive function, or memory after adjusting for covariates. Female sex was associated with lower sodium excretion (all P<0.01); individuals with knowledge of sodium guidelines had less intake of sodium, resulting in excretion of less sodium (all P≤0.03). Conversely, higher socioeconomic status (SES) and body mass index (BMI) were associated with greater sodium (all P≤0.02 and P≤0.01). Adherence to urine sodium collection was poor, especially among those with poorer cognitive function. Sodium consumption exceeded recommended amounts and was unrelated to cognitive function. Interventions for improving sodium adherence should focus on at-risk groups (high SES and BMI) and at improving knowledge of recommended salt intake.